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1

Preventive echocardiographic examination in athletes and workers – Quadricuspid aortic valve and atrial septal aneurysm in a young basketball player

100%

Wierzbowska-Drabik K., Marcinkiewicz A., Kasprzak J. D.

International Journal of Occupational Medicine and Environmental Health

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2015

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vol. 28

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issue 1

180-182

EN

Ensuring safety of young athletes and employees who perform hard physical work within the scope of their professional duties, with a special focus on prevention of a sudden cardiac death at sports fields or during hard physical work is one of the most important tasks, which demands joint effort of cardiologists and sport physicians or occupational physicians, who qualify patients for a job or a sport discipline. Apart from hypertrophic and arhythmogenic right ventricular cardiomyopathy, coronary anomalies and aortic dissection belong to the most frequent causes of dramatic complications during competitive exercise or work with an increased energy expenditure. Although a detailed medical history and a physical examination combined with 12-lead ECG assessment may significantly improve the safety in competitive sports, adding echocardiography examination gives a detailed and noninvasive insight into the heart morphology and function. Therefore, in our opinion, it should constitute a standard part of the evaluation of candidates for competitive sports. The practice indicates that beyond subjects with severe heart diseases and those classified as normal, there is a group of individuals with abnormalities which should be more closely monitored, but are not contraindications against professional sports or work with an increased energy expenditure. We describe the case of a young female with a diagnosis of rare congenital aortic valve disease, quadricuspid valve, with mild regurgitation and atrial septal aneurysm which was established during transthoracic echocardiography and confirmed and expanded during TEE examination.

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Broken heart as work-related accident: Occupational stress as a cause of takotsubo cardiomyopathy in 55-year-old female teacher – Role of automated function imaging in diagnostic workflow

76%

Mielczarek A., Kasprzak J. D., Marcinkiewicz A., Kurpesa M., Uznańska-Loch B., Wierzbowska-Drabik K.

International Journal of Occupational Medicine and Environmental Health

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2015

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vol. 28

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issue 6

1031-1034

EN

Takotsubo cardiomiopathy (TTC) (known also as “ampulla cardiomyopathy,” “apical ballooning” or “broken heart syndrome”) is connected with a temporary systolic left ventricular dysfunction without the culprit coronary lesion. Takotsubo cardiomyopathy was first described in 1990 in Japan after octopus trapping pot with a round bottom and narrow neck similar in shape to left ventriculogram in TTC patients. The occurrence of TTC is usually precipitated by a stressful event with a clinical presentation mimicking myocardial infarction: chest pain, ST-T segment elevation or T-wave inversion, a rise in cardiac troponin, and contractility abnormalities in echocardiography. A left ventricular dysfunction is transient and improves within a few weeks. Takotsubo cardiomyopathy typically occurs in postmenopausal women and the postulated mechanism is catecholamine overstimulation. Moreover, the distribution of contractility impairments usually does not correspond with typical region supplied by a single coronary artery. Therefore, the assessment of regional pattern of systolic dysfunction with speckle-tracking echocardiography and automated function imaging (AFI) technique may be important in diagnosis of TTC and may improve our insight into its patophysiology. We described a 55-year-old female teacher with TTC diagnosed after acute psychological stress in workplace. The provoking factor related with occupational stress and pattern of contraction abnormalities documented with AFI technique including basal segments of left ventricle make this case atypical.

3

Cardiotoxic effect due to accidental ingestion of an organic solvent

64%

Cieślik-Guerra U. I., Rechciński T., Trzos E., Wierzbowska-Drabik K., Uznańska-Loch B., Winnicka R., Krakowiak A., Kasprzak J. D., Fröhlich C., Kurpesa M.

International Journal of Occupational Medicine and Environmental Health

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2015

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vol. 28

|

issue 1

174-179

EN

Toxic myocardial injury can be misdiagnosed as a myocardial infarction, resulting in the patient undergoing standard treatment for cardiac rehabilitation. However, such inadequate therapeutic strategies can lead to cardiovascular complications including dilated cardiomyopathy. This study presents a case of a 65-year-old man after accidental ingestion of organic solvents (toluene and xylene), whose condition demonstrated all the criteria for diagnosis of myocardial infarction. The qualitative determinations of the above mentioned volatile organic compounds (VOCs) in whole blood were carried out using a headspace sampling by means of gas chromatography. Cardiac catheterization revealed no specific coronary lesions, only a muscular bridge causing a 30–50% stenosis in the middle of the circumflex branch of the left coronary artery.

4

Takotsubo cardiomyopathy in the case of 72-year-old teacher after work-related psychological stress. Evolution of left ventricular longitudinal strain – Delayed but complete recovery in automated function imaging (AFI)

64%

Wierzbowska-Drabik K., Marcinkiewicz A., Hamala P., Trzos E., Lipiec P., Kurpesa M., Kręcki R., Plewka M., Kasprzak J. D.

International Journal of Occupational Medicine and Environmental Health

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2017

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vol. 30

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issue 4

681-683

EN

Takotsubo cardiomyopathy (TC) is related to a transient systolic dysfunction of left ventricle (LV), accompanied by clinical and electrocardiographic symptoms of myocardial ischemia in the absence of hemodynamically significant coronary artery disease. Takotsubo cardiomyopathy is usually provoked by a psychologically or/and physically stressful event which may be related to occupational activities. Although visually assessed evolution of LV function is well documented, the data concerning strain changes is sparse and various patterns of deformation abnormalities are suggested. We have described a 72-year-old woman with chest pain related to a lecture given at the meeting of the Senior University, fulfilling all the Mayo Clinic criteria of the TC. The longitudinal strain analysis with automated function imaging (AFI) documented severe impairment and stepwise recovery of regional and global LV contractility. The case described confirms that accurate diagnosis, treatment and documenting of functional improvement in takotsubo cardiomyopathy may enable the return to occupational activities even for elderly persons. Int J Occup Med Environ Health 2017;30(4):681–683

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4 International Journal of Occupational Medicine and Environmental Health

4 Kasprzak J. D.

4 Wierzbowska-Drabik K.

3 Kurpesa M.

3 Marcinkiewicz A.

2 Trzos E.

2 Uznańska-Loch B.

1 Cieślik-Guerra U. I.

1 Fröhlich C.

1 Hamala P.

1 Krakowiak A.

1 Kręcki R.

1 Lipiec P.

1 Mielczarek A.

1 Plewka M.

1 Rechciński T.

1 Winnicka R.

1 2017

3 2015

Preventive echocardiographic examination in athletes and workers – Quadricuspid aortic valve and atrial septal aneurysm in a young basketball player

Broken heart as work-related accident: Occupational stress as a cause of takotsubo cardiomyopathy in 55-year-old female teacher – Role of automated function imaging in diagnostic workflow

Cardiotoxic effect due to accidental ingestion of an organic solvent

Takotsubo cardiomyopathy in the case of 72-year-old teacher after work-related psychological stress. Evolution of left ventricular longitudinal strain – Delayed but complete recovery in automated function imaging (AFI)